Lead Poisoning in United States-Bound Refugee Children: Thailand-Burma Border, 2009

Mitchell, Tarissa; Jentes, Emily S.; Ortega, Luis; Sucosky, Marissa Scalia; Jefferies, Taran; Bajcevic, Predrag; Parr, Valentina; Jones, Warren L.; Brown, Mary Jean; Painter, John A.

doi:10.1542/peds.2011-1218

Cited by 34 publications

(37 citation statements)

References 21 publications

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“…Moreover, we identified EBLLs in 30.6% of all children, an alarming rate considering the neurotoxic potential of Lead, its negative impact on cognitive function and attention span [21, 39–41]. Due to accumulating evidence regarding the significant and irreversible adverse effects of even low levels of circulating blood Lead, the Centers for Disease Control and Prevention (CDC) decreased in 2012 the respective “reference level” to 5 μg/dL, stating however that no level of Lead is considered safe.…”

Section: Discussionmentioning

confidence: 99%

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

et al. 2017

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BackgroundMigrant children are a population at risk for various health problems. Despite the increased inflow of migrants in Greece, data regarding their health assessment are lacking. This study aims to describe the clinical and certain laboratory characteristics and identify possible associations in a group of new immigrant (I) and refugee (R) children, arriving in Athens, Greece.MethodsA prospective, cross- sectional study was performed in a migrant outpatient clinic of a tertiary Children’s hospital. All immigrant and refugee children, examined to obtain a health certificate, within 3 months of their arrival in the country, were enrolled. Clinical and laboratory information was collected in a pre- designed form. We applied multiple logistic regression models to investigate the association between the child’s status (immigrant vs refugee) and health indicators controlling for possible confounding effects, mainly of age and area of origin.ResultsFrom 2010 to 2013, a total of 300 children (I/R:138/162) with a mean age of 7.08 (range 1–14) years were included. Overall, 79.3% presented unknown vaccination status, 21.3% dental and 7.3% additional clinical problems. Latent tuberculosis was identified in 2.7%, while anemia, low serum ferritin and eosinophilia were found in 13.7%, 17.3%, and 22.7% of subjects, respectively. 57.7% had protective antibodies to hepatitis B surface antigen (anti-HBs ≥ 10 IU/L) and 30.6% elevated blood lead levels (EBLLs). Immigrants had less likely unknown immunization (OR = 0.25, p < 0.001), but had increased odds of low ferritin (OR = 1.97, p = 0.043), EBLLs (OR = 2.97, p = 0.001) and protective anti-HBs (OR = 1.79, p = 0.03). Age was inversely associated with anemia (OR = 0.0.89, p = 0.017), low ferritin (OR = 0.91, p = 0.027), EBLLs (OR = 0.86, p = 0.001) or positive anti-HBs (OR = 0.92, p = 0.025). Children from Europe or Africa presented decreased probability of EBLLs (OR = 0.31, p = 0.001, and OR = 0.15, p = 0.005, respectively) compared to those from Asia.ConclusionsNew immigrant and refugee children presented distinct clinical problems and certain laboratory abnormalities. Some of these health issues differed according to their migration status, age and geographic area of origin. These findings provide evidence that may assist the optimal approach of this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

et al. 2017

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“…25 Furthermore, several studies have shown an increase in acute and chronic malnutrition, including micronutrient and vitamin deficiencies in refugee camps in Jordan 26 and Nepal. 27 In addition, elevated levels of lead in toxic concentrations have been found in refugee camps in Thailand 28 and Somalia (►Fig. 2).…”

Section: Refugee Campsmentioning

confidence: 99%

Understanding Refugees' Health

Mûller

Khamis²,

Srivastava

et al. 2018

Semin Neurol

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According to the United Nations Refugee Agency (UNHCR), 65.6 million people have been forcibly displaced worldwide. Several factors have a major influence on asylum seekers' health; so, their health profile is markedly different from that of the population in the country of asylum. The aim of this study is to review the major issues physicians need to be aware of when treating asylum seekers, with a special focus on the neurological problems of asylum seekers and refugees. The major impact factors on refugees' health are linked to experiences and exposure (1) in the country of origin, (2) in refugee camps and en route to Europe, and (3) in the process of immigration into the host country and living in European asylum centers. Refugees' health is also affected by psychological problems and by infectious diseases. Additionally, chronic diseases resulting in polymorbidity, cancer, and neurological diseases are easy to overlook and demand special attention. Neurological injuries/diseases may be traumatic (e.g., spinal cord injuries), posttraumatic (e.g., chronic pain syndromes), the result of cerebral infections, or the consequences of starvation (e.g., epilepsy, ataxia, and paraesthesia). The main challenges for physicians are lack of awareness of the asylum seekers' specific health care problems, language and intercultural communication problems, as well as access and integration of asylum seekers into the health care system. The health issues of asylum seekers are manifold and challenging to physicians. Awareness of these conditions is mandatory to ensure good clinical practice for this patient population, which has a huge burden in chronic, infectious, mental, and neurological diseases.

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“…The elevation was caused by premigration exposure to car batteries and contaminated traditional medicines. 11,12 This led to premigration interventions, as well as the US engaging the IRHWG to disseminate its data. At that time, one-third of Australia-bound refugees came from the Burma region 13 , so Australia capitalised on the shared data and action to minimise the risk of lead harm to refugees resettling here.…”

Section: Information Exchangementioning

confidence: 99%

Intergovernmental collaboration for the health and wellbeing of refugees settling in Australia

Martin

Douglas²

2018

Public Health Res Pr

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As outlined in the Department of Immigration and Border Protection Annual report , Australia granted 21 928 humanitarian visas in 2016-17, 13 760 of them offshore. This number will increase in future to a planned offshore program of 18 750 in 2018-19. The report notes that the United Nations High Commissioner for Refugees ranks Australia third for the number of refugees resettled. With such a massive program and commitment by the Australian Government, the need to ensure that health and wellbeing are maintained or gained during the settlement process is paramount. This article outlines how collaboration between like-minded national governments can improve premigration health screening through information sharing, collaborative learning and increased capability in countries of origin to not only screen for illness and disability, but to more effectively put measures in place to address these before, during and after arrival. Australia, Canada, New Zealand, the UK and the US have worked together for more than a decade on migration health screening policies to ensure better management of health needs and successful resettlement. A case study about the Syrian refugee cohort, which began arriving in Australia in late 2015, illustrates how intergovernmental collaboration can improve settlement.

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Lead Poisoning in United States-Bound Refugee Children: Thailand-Burma Border, 2009

Cited by 34 publications

References 21 publications

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

Clinical and laboratory evaluation of new immigrant and refugee children arriving in Greece

Understanding Refugees' Health

Intergovernmental collaboration for the health and wellbeing of refugees settling in Australia

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